Paliperidone and Pimozide interaction

Paliperidone and Pimozide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Pimozide label · effective 2026-08-12

Major

Because pimozide prolongs the QT interval of the electrocardiogram it is contraindicated in patients with congenital long QT syndrome, patients with a history of cardiac arrhythmias, patients taking other drugs which prolong the QT interval of the electrocardiogram or patients with known hypokalemia or hypomagnesemia (see also PRECAUTIONS - DRUG INTERACTIONS ).

Contraindicationsby drug classView label on DailyMed
Minor

Hyperpyrexia, not associated with the above symptom complex, has been reported with other antipsychotic drugs.

Warningsby drug classView label on DailyMed

From the Paliperidone (Erzofri extended-release) label · effective 2026-03-09

Moderate

…combination with other drugs that are known to prolong QTc including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval.

Warnings and precautionsby drug classView label on DailyMed
Moderate

ERZOFRI and other antipsychotic drugs should be used cautiously in patients at risk for aspiration.

Warnings and precautionsby drug classView label on DailyMed
Minor

Paliperidone has a prolactin-elevating effect similar to that seen with risperidone, a drug that is associated with higher levels of prolactin than other antipsychotic drugs.

Warnings and precautionsby drug classView label on DailyMed
Minor

Like other antipsychotic drugs, ERZOFRI should be used cautiously in patients with a history of seizures or other conditions that potentially lower the seizure threshold.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.